Department of Family Medicine, Preventive Medicine, and Community Health, Kirksville College of Osteopathic Medicine, A.T. Still University, 800 W. Jefferson St., Kirksville, MO 63501, USA.
Kirksville College of Osteopathic Medicine, A.T. Still University, 800 W. Jefferson St., Kirksville, MO 63501, USA.
J Neurol Sci. 2019 Sep 15;404:150-156. doi: 10.1016/j.jns.2019.07.033. Epub 2019 Jul 31.
Inversion tables are used as treatment for back pain, but there is a lack of agreement on systemic effects of inversion.
To assess intracranial pressure (ICP) and cerebral blood flow using ultrasonography during inversion table tilt.
Optic nerve sheath diameter (ONSD), heart rate (HR), blood pressure, internal carotid artery (ICA) and middle cerebral artery (MCA) blood flow of participants were measured in 3 positions: supine before inversion, during inversion with head down, and supine post-inversion. ONSD was evaluated with ocular ultrasonography and blood flow (ICA and MCA) with Doppler ultrasonography.
The ONSD changed significantly between the supine position, at 3 min of inversion, and after returning to supine position (all P < .001). The post-inversion HR was less than pre-inversion (P = .03) and 3-min inversion HR (P = .003). There were significant changes in ICA and MCA flow caused by inversion, which affected blood flow velocity, resistance, and pulsatility index (all P ≤ .005).
Inversion caused significant changes in ICP and blood flow. Thus, increased chance of complications may exist when using inversion as a therapeutic tool or during surgical procedures in patients with previous history of elevated ICP. These results demonstrate that inversion therapy should be used with caution.
倒立仪被用作治疗背痛的方法，但倒立对颅内压（ICP）和脑血流的全身性影响尚未达成共识。
使用超声检查评估在使用倒立仪倾斜时的颅内压（ICP）和脑血流。
参与者在 3 个位置测量视神经鞘直径（ONSD）、心率（HR）、血压、颈内动脉（ICA）和大脑中动脉（MCA）的血流：仰卧位在开始倒立前、头朝下倒立期间和倒立后仰卧位。使用眼部超声检查评估 ONSD，使用多普勒超声检查评估 ICA 和 MCA 的血流。
ONSD 在仰卧位、3 分钟倒立位和恢复仰卧位之间发生显著变化（均 P<0.001）。与倒立前相比，倒立后 HR 更低（P=0.03），与 3 分钟倒立 HR 相比也更低（P=0.003）。倒立引起 ICA 和 MCA 血流的显著变化，影响血流速度、阻力和搏动指数（均 P≤0.005）。
倒立引起 ICP 和血流的显著变化。因此，在使用倒立作为治疗工具或在有颅内压升高病史的患者进行手术时，可能存在并发症增加的风险。这些结果表明，倒立治疗应谨慎使用。
